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. 2021 Mar 30;13(4):577.
doi: 10.3390/v13040577.

Increasing Capacity to Detect Clusters of Rapid HIV Transmission in Varied Populations-United States

Alexandra M Oster  1   2 , Nivedha Panneer  1 , Sheryl B Lyss  1   2 , R Paul McClung  1   2 , Meg Watson  1 , Neeraja Saduvala  3 , M Cheryl Bañez Ocfemia  1 , Laurie Linley  1 , William M Switzer  1 , Joel O Wertheim  4 , Ellsworth Campbell  1 , Angela L Hernandez  1 , Anne Marie France  1   2
Affiliations

Increasing Capacity to Detect Clusters of Rapid HIV Transmission in Varied Populations-United States

Alexandra M Oster et al. Viruses. .

Abstract

Molecular cluster detection analyzes HIV sequences to identify rapid HIV transmission and inform public health responses. We describe changes in the capability to detect molecular clusters and in geographic variation in transmission dynamics. We examined the reporting completeness of HIV-1 polymerase sequences in quarterly National HIV Surveillance System datasets from December 2015 to December 2019. Priority clusters were identified quarterly. To understand populations recently affected by rapid transmission, we described the transmission risk and race/ethnicity of people in clusters first detected in 2018-2019. During December 2015 to December 2019, national sequence completeness increased from 26% to 45%. Of the 1212 people in the 136 clusters first detected in 2018-2019, 69% were men who have sex with men (MSM) and 11% were people who inject drugs (PWID). State-by-state analysis showed substantial variation in transmission risk and racial/ethnic groups in clusters of rapid transmission. HIV sequence reporting has increased nationwide. Molecular cluster analysis identifies rapid transmission in varied populations and identifies emerging patterns of rapid transmission in specific population groups, such as PWID, who, in 2015-2016, comprised only 1% of people in such molecular clusters. These data can guide efforts to focus, tailor, and scale up prevention and care services for these populations.

Keywords: HIV-1; cluster analysis; epidemiology; intravenous; public health; sexual and gender minorities; substance abuse.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Sequence completeness (percentage of diagnoses in the past 3 years with an HIV sequence available), by quarterly dataset, in Ending the HIV Epidemic (EHE) priority areas, all areas, and areas not previously funded to collect sequence data before 2018.
Figure 2
Figure 2
Transmission category of people in clusters of rapid transmission first detected during 2018–2019, overall and in selected states (those with at least 20 cluster members). MSM: men who have sex with men; PWID: people who inject drugs.
Figure 3
Figure 3
Race/ethnicity of people in clusters of rapid transmission first detected during 2018–2019, overall and in selected states (those with at least 20 cluster members).
See this image and copyright information in PMC

References

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